Effect of flunarizine on global brain ischemia in the dog: a quantitative morphologic assessment

The effects of flunarizine, a calcium antagonist, were evaluated in an experimental model of global brain ischemia produced by 15 min of cardiac arrest followed by resuscitation and reperfusion. One group of dogs received flunarizine (0.1 mg/kg intravenously during a 10-min period) at the onset of resuscitation. Another group of dogs underwent cardiac arrest, resuscitation, and reperfusion but did not receive flunarizine. A third group served as nonischemic control. In situ-fixed brains of all animals (nonischemic controls and the postischemic dogs after 8 h of reperfusion) were examined for anoxic ischemic injury. Quantitation of the ischemic neurons was carried out in parietal cortex, hippocampus, and cerebellum by using an image analysis system. Significant difference in the number of necrotic neurons between the flunarizine-treated group and the ischemic controls was noted in the hippocampus only; the mean percentage of necrotic neurons in the two groups being 14.8 +/- 9.6 and 29.3 +/- 12.1, respectively (P less than 0.05). These results indicate that flunarizine has an ameliorating effect on neuronal injury in the hippocampus that follows cardiac arrest in this experimental model of global brain ischemia. However, flunarizine was not found to be effective in reducing the ischemic neuronal damage in the cortex or the cerebellum.

Decline in cerebral glucose utilisation and cognitive function with aging in Down's syndrome

The cerebral metabolic rate for glucose (CMRglc) was measured with positron emission tomography and [18F]2-fluoro-2-deoxy-D-glucose in 14 healthy subjects with Down's syndrome, 19 to 33 years old, and in six healthy Down's syndrome subjects over 35 years, two of whom were demented. Dementia was diagnosed from a history of mental deterioration, disorientation and hallucinations. All Down's syndrome subjects were trisomy 21 karyotype. CMRglc also was examined in 15 healthy men aged 20-35 years and in 20 healthy men aged 45-64 years. All subjects were at rest with eyes covered and ears plugged. Mean hemispheric CMRglc in the older Down's syndrome subjects was significantly less, by 23%, than in the young Down's syndrome group; statistically significant decreases in regional metabolism (rCMRglc) also were present in all lobar regions. Comparison of the younger control group with the older control group showed no difference in CMRglc or any rCMRglc (p greater than 0.05). Assessment of language, visuospatial ability, attention and memory showed significant reductions in test scores of the old as compared with the young Down's syndrome subjects. These results show that significant age differences in CMRglc and rCMRglc occur in Down's syndrome but not in healthy controls, and that, although only some older Down's syndrome subjects are demented, significant age reductions in neuropsychologic variables occur in all of them.

The influence on patients' pain intensity ratings of antecedent reinforcement of pain talk or well talk

This study sought to determine whether positive verbal reinforcement for pain talk or well talk could effectively influence chronic pain patients' subsequent ratings of pain intensity. Four female chronic pain inpatients were each exposed over seven consecutive days to two conditions within an alternating treatments design. Inter-rater reliability analysis from the audiotapes on occurrences of pain and well talk, verbal reinforcement and appropriate reinforcement of verbal behavior across conditions resulted in agreement values from 91 to 100%. Findings revealed that subjects' pain intensity ratings were consistently and significantly lower after verbally reinforcing well talk compared with verbally reinforcing pain talk.

Botryomycosis of the oral regions

Botryomycosis is an unusual bacterial infection capable of producing chronic granulomatous inflammation and characterised by the production of distinctive grains formed by the interaction of the infective bacteria with the host tissues. The occurrence of this infection in a healthy individual generally results in locally destructive lesions which can clinically mimic a sarcoma. A case is reported involving the oral regions of a healthy adult male which illustrated these features and a discussion is presented of the diagnostic features of this condition.

Alfentanil for short duration laparoscopic procedures

Alfentanil in low dosage (8 micrograms kg-1) as an analgesic agent for short duration surgery was evaluated. Forty-one women undergoing laparoscopy received double-blind either alfentanil 8 micrograms kg-1 or normal saline at induction, and all received thiopentone, alcuronium, enflurane, nitrous oxide and oxygen. The fall in mean arterial pressure (MAP) with induction was similar between groups. The MAP following intubation with alfentanil was unchanged, while with normal saline a mean rise of 23 (SD 15.2) mmHg occurred (P less than 0.001). The pulse rate following intubation showed a smaller rise (P less than 0.001) with alfentanil of 26 (SD 14.6) beats min-1, than the normal saline group of 46 (SD 13.3) beats min-1. Alfentanil was found to be a safe and effective analgesic agent in short duration surgery, by reducing sympathetic responses to intubation without cardiovascular depression or compromise of postoperative recovery.

The use of the carbon dioxide laser in head and neck lymphangioma

The carbon dioxide laser has been used to treat various lesions of the head and neck, ranging from carcinomas to hemangiomas, and even including tatoos. A search of the literature does not reveal any reports of the carbon dioxide laser being used to treat lymphangioma. This report discusses the efficacy of treating lymphangioma of the air and food passages with the carbon dioxide laser, and presents three patients who have been treated in this fashion-two for palliation and one for cure.

Type I tympanoplasty: influencing factors

Type I tympanoplasties utilizing an underlay technique with temporalis fascia performed at the Medical University associated hospitals over a 5-year period were reviewed. Cases were excluded if follow-up was less than 18 months or if a previous tympanoplasty had been performed. The remaining 71 cases, 40 adults and 25 children, were analyzed for influencing factors. The overall success rate was 89%. The age of the patient, the length of time the ear had been dry, and the presence of infection at the time of surgery had no influence on the success rate. The two factors which adversely influenced the success rate were the presence of a near total or total perforation and the presence of bilateral perforations.

A family planning risk scoring system for health care providers

The potential usefulness of a Family Planning Risk Scoring Sheet was studied in 1720 consecutive women who completed a family planning visit and were prescribed a specific contraceptive method. The results demonstrated that many women had relative or absolute contraindications to their prescribed method that were detected later by the Family Planning Risk Scoring Sheet. There were 29 women in the oral contraceptive and intrauterine device groups who had absolute contraindications detected (2.8 and 2.4%, respectively). The nurse practitioners tended to have fewer unrecognized problems in their groups than did the physicians. The usefulness of the Family Planning Risk Scoring Sheet was demonstrated and its routine use in a busy family planning unit is recommended.

Is there a bias in size measurements taken from mirror-reversed photographs of body parts?

This study compared measurements of hands, feet, and hemifaces taken from original and mirror-reversed photographs to determine whether a hemispace-bias exists in size measurements. Posers were adult right- and left-handers (50% female). In 80% of the measurement comparisons (total N = 84), there was complete agreement; there were no instances of right-left reversals among the discrepant comparisons. The side of the body measured as larger was independent of the side of space in which it appeared. The lack of such bias in physical measurements is discrepant with data suggesting a left-hemispace preference in psychological judgments of visual material.

Facial asymmetry in posed and spontaneous expressions of emotion

Patterns of facial asymmetry (i.e., extent of movement) as a function of elicitation condition, emotional valence, and sex of subjects are examined. Thirty-seven right-handed adult males and females were videotaped making positive and negative expressions of emotion under posed (verbal, visual) and spontaneous conditions. There were no differences in facial asymmetry as a function of condition. Overall, expressions were significantly left-sided, a finding implicating the right hemisphere. When sex and valence were considered, negative expressions were left-sided for all subjects, while positive expressions were left-sided for males only. Further, positive expressions were significantly less lateralized than negative ones for females. Measures of hemiface mobility and ocular dominance did not mediate these patterns of facial lateralization.

Asymmetries in body part size, mobility, and usage. Relationship between structure and function

Asymmetries in structure (size) and function (usage or mobility) for the upper and lower face, hands, and feet were investigated in 42 left- and right-handed male and female college students. Size measurements were taken from photographs, mobility was rated from videotapes, and usage was assessed by questionnaire. Size asymmetries were typical, and independent of handedness, but were not consistent across body parts; usage asymmetries varied as a function of handedness. No systematic relationships were found between structure and function.

A left hemispace bias for visualizing emotional situations

Forty-three college-aged subjects posed a series of emotional facial expressions and described their strategies for creating such expressions. The majority of subjects (86%) reported visualizing an image or situation. When asked for the location of the image, the majority (62%) indicated the left hemispace, and only 5% indicated the right.

Comparison of red cell and kidney (Na+ +K+)-ATPase at 0 degrees C

Human red cell and guinea pig kidney (Na+ +K+)-ATPase were phosphorylated at 0 degrees C. Using concentrations of ATP ranging from 10(-6) to 10(-8) M, ATP-dependent regulation of reactivity is observed with red cell but not kidney (Na+ +K+)-ATPase at 0 degrees C. In particular, with the red cell enzyme only, the following are observed: (i) the ratio of enzyme-bound ATP (E.ATP, measured by the pulse-chase method of Post, R.L., Kume, S., Tobin, T., Orcutt, B. and Sen, A.K. (1969) J. Gen. Physiol. 54, 306s-326s) to steady-state level of total phosphoenzyme (EP) decreases with decrease in ATP concentration and (ii) the apparent turnover of phosphoenzyme (ratio of Na+-stimulated ATP hydrolysis to level of total EP at steady state) also varies as a function of ATP concentration. In addition, when EP is formed at very low ATP (0.02 microM), and then EDTA is added, rapid disappearance of a fraction of EP occurs, presumably due to ATP resynthesis, only with the red cell enzyme. These differences in behaviour of the red cell and kidney enzymes are explained on the basis of the observed predominance of K+-insensitive EP in red cell, but K+-sensitive EP in kidney (Na+ +K+)-ATPase at 0 degrees C.

The treatment of giant hairy naevi by dermabrasion in the first few weeks of life. Case reports

A method for treating congenital giant naevi in the first few weeks of life by mechanical dermabrasion is described. From reports in the literature and from our 2 cases it would seem that this is a very effective method for removing pigmentation early in life. The cosmetic deformity of these lesions is eradicated and their malignant potential possibly minimized.